Symptoma

Leukemia Cutis

Presentation

The section Cases presents brief case reports that convey clear, practical lessons. Preference is given to common presentations of important rare conditions, and important unusual presentations of common problems.[cmaj.ca]

The authors present a unique case of a patient with APL who developed LC that clinically mimicked a disseminated herpes zoster infection. This is only the second reported case of LC as the presenting sign of APL.[jcadonline.com]

Case report A 53-year-old male was referred to Konkuk University Chungju Hospital (Chungju, Korea) for generalized cutaneous nodules on the face, anterior chest wall and legs ( Fig. 1 ), as well as a sorethroat.[spandidos-publications.com]

There was no history of drug allergy, joint pains, chronic cough, fever, weight loss, hemoptysis, hematuria, photosensitivity, or any major medical or surgical illness in the past. Family and personal history were not significant.[jahjournal.org]

Workup

The traditional backbone of initial workup of AL, of acute leukemia, is composed of ctyomorphology, cytochemistry, immunophenotyping, and molecular cytogenetics. These techniques are the backbone of the initial diagnostic workup of acute leukemia.[ivoox.com]

If the patient develops high unrelenting fevers, especially during the course of treatment, an infectious workup is necessary as these patients are immunocompromised and prone to infections.[ncbi.nlm.nih.gov]

Clinical Testing and Workup Laboratory tests will include a complete blood count and a peripheral blood smear.[rarediseases.org]

Treatment

“Identifying a cohort of patients who may benefit from more intensive treatment is clinically relevant. However, having more intensive therapy may not necessarily improve treatment outcomes,” he cautioned.[cancernetwork.com]

Therapy-related acute myeloid leukaemia (t-AML) is a complication following exposure to cytotoxic agents used in the treatment of various primary malignancies (1).[medicaljournals.se]

Only 24 patients with APL have been reported to have developed LC.[22–26] Interestingly, in all of these cases, the rash appeared to be induced by treatment with ATRA.[22–26] ATRA treatment is associated with an increased incidence of extramedullary disease[jcadonline.com]

Prognosis

[…] with worse prognosis Spontaneous regression of LC without treatment has been observed Prognosis in CLL patients is good Exception of blastic transformation (Richter syndrome) is associated with poor prognosis MICROSCOPIC PATHOLOGY General Histologic[basicmedicalkey.com]

A diagnosis of leukemia cutis generally portends a poor prognosis and strongly correlates with additional sites of extramedullary involvement.[ncbi.nlm.nih.gov]

Previous reports have suggested poor prognosis for patients with LC, but these reports have largely consisted of descriptive studies with a limited number of patients.[jamanetwork.com]

Because it correlates with sites of additional extramedullary involvement, it typically portends a poor prognosis.[mdedge.com]

Leukemia cutis is especially rare as the presenting symptom of leukemia and is associated with a poor prognosis.[escholarship.org]

Etiology

Both genetic and environmental components are involved in the etiology of any leukemia and are responsible for maturation arrest and clonal expansion of precursor cells.[ncbi.nlm.nih.gov]

Leukemia cutis commonly used to describe lymphocytic leukemias involving skin Designated by precursor B- or T-cell lineage and chronic lymphocytic leukemia “Myeloid sarcoma” is preferred term when leukemic cells are of myeloid or monocytic lineage ETIOLOGY[basicmedicalkey.com]

Depending on the lesion’s appearance, the differential diagnoses can include lymphoma, drug eruptions, infectious etiologies, sarcoidosis, metastases from other malignancies, and blistering dermatoses.[mdedge.com]

Bacterial, fungal, and mycobacterial cultures should also be obtained to evaluate for possible infectious etiology [9]. Our patient’s lesions were a cutaneous manifestation of his underlying plasma cell leukemia.[cureus.com]

(This is an excellent recent review of the clinical manifestations, epidemiology, and histopathology. It discusses and compares the histopathology and immunophenotypes of several types of LC. There are several clinical and histologic photographs.)[dermatologyadvisor.com]

Pathophysiology

The pathophysiology of leukemia cutis involves the migration of leukemic cells into the skin.[ncbi.nlm.nih.gov]

Pathophysiology All types of leukemia result from the abnormal development of leukocytes in the bone marrow.[emedicine.medscape.com]

In the latter, a drastic change in chemotherapy regimen will be needed. [11] LC is often associated with many other sites of extensive involvement, and generally a very poor prognosis has been noted. [12], [13], [14], [15] The pathophysiology and mechanism[ijmpo.org]

[…] molecule-1 and lymphocyte function-associated antigen-1 has been hypothesized to be involved. 113 Future studies Establishing the underlying molecular basis for the migration of leukemia cells to specific sites is critical to understanding the specific pathophysiology[bloodjournal.org]

Prevention

Salvage chemotherapy has been applied successfully to prevent the development of LC in the patient's skin. Introduction Leukemia cutis (LC) is known as a general term for skin lesions caused by leukemia 1.[bmrat.org]

Antimicrobials Most patients will also receive antimicrobials as a preventative measure against infections after these skin lesions are found.[leukaemiacare.org.uk]

[…] skin relapse. 8 It has been suggested that aggressive chemotherapy should continue even after remission to prevent further relapse. 2 The prognosis of leukemia cutis tends to be grave, with 88% of patients dying within one year of diagnosis. 1,3,5 Another[the-dermatologist.com]

Therefore, new research directions are crucial to predict, prevent and combat virus diseases. This Special Issue will include manuscripts on different aspects of virus diseases in both humans and animals.[mdpi.com]

Chemotherapy can reduce the number of cancerous cells in the body and prevent new cells from forming.[rarediseases.org]